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Is Luteal Support Necessary for Natural FET?

FET progesterone

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#1 keepsontrying

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Posted 02 February 2017 - 09:18 AM

Hi Dr.,

 

Can you please provide me with insight into why luteal support is recommended during natural FETs if the woman has no infertility factors?

 

Some background: I'm getting ready for FET (with letrozole & hcg trigger) because of male infertility factor. I'm 32, ovulate regularly with 29 day cycles. I have repeated implantation failure (5 failed eSET transfers--2 chems & 3 neg), an ovarian cyst removed a while back, and an EFT that showed slight receptivity problem, which was hopefully just treated. My doctor strongly recommends luteal support for all FETs with estrace and progesterone suppositories, which I've always done in the past, but I can't get a clear understanding of why--is this done to increase receptivity or just in case I don't produce enough naturally? Any insight would be very helpful!

 

Thanks!



#2 DrMichaelHartman

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Posted 05 February 2017 - 11:08 AM

Great question!

Typically, the concern is that your body would not produce enough naturally, so it is supplemented. Especially in cases of an abnormal EFT and recurrent implantation failure, most physicians would suggest luteal support.

However, theoretically if you do a natural cycle and ovulate, the corpus luteum should make enough progesterone in MOST (but not all) women to support early pregnancy. 

Given the history I would likely do the same thing as your physician

 

Good luck!


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#3 keepsontrying

keepsontrying
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Posted 06 February 2017 - 09:54 AM

Hi Dr. Hartman, Thank you so much for your quick response. It was really helpful for me!



#4 dallz

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Posted 16 March 2017 - 09:41 PM

I had a similar issue ( 7 chemicals in a row) and the protocol that finally worked for me after everything including a failed FET was the following:

Femara days 5-9
Trigger shot pregnyl 10,000 units even though i ovulate on my own
And most important part: another pregnyl shot 10.000 units again 6 days after trigger to prolong lutheal phase.
Progesterone supps until heartbeat scan 3 x a day

This protocol lead to my success, good luck!

#5 keepsontrying

keepsontrying
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Posted 17 March 2017 - 08:35 AM

Thanks dallz and congrats! My RE said femara/letrozole has high success rates.

I used it for my last two cycles (after taking it continuously for 2 months with bcp to hopefully improve receptivity) along with luteal support, a scratch and an hcg uterine wash, but I had another chemical with another pgs-tested blast. I finally agreed to go back to hormone replacement cycles complete with lupron and more femara. Now I'm doing a mock cycle with another biopsy to see if my receptivity is improved with the new protocol before transferring our last normal blast. I'll repeat the wash again too. I'm desperately trying to avoid the 3 months of lupron depot. More suggestions always welcome!





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